HAGOS to HOOS – offspring or cousin?

The Copenhagen Hip dysfunction and Osteoarthritis Outcome Score (HOOS) is a popular, well known tool used in OA of the hip – to track the results of interventions such as hip arthroplasty as well as non-surgical treatments in individuals and groups.

It was originally validated in a population aged 42-89 and includes the WOMAC Osteoarthritis Index (which can be calculated from it and which in turn, is validated in elderly subjects with hip OA). As such, it is not a useful tool for a more active population.

Hence its cousin – The Copenhagen Hip and Groin Outcome Score (HAGOS). HAGOS was developed in accordance with the (new at the time) COSMIN checklist.

HAGOS can be used in a young active population with hip or groin problems.

The HAGOS shares many of the same items as HOOS but includes more questions on “participation in physical activities” and “function in sport and recreation”, and less in “physical function in daily living”. Some of these questions were also derived from the Hip Outcome Score (HOS- frequently used to track outcomes of hip arthroscopy). Its questions relate to the “hip and / or groin”. It was originally validated for use in active patients (those participating in 2.5 hours or more per week of physical activity) aged 18-63 years.

The Copenhagen Hip And Groin Outcome Score – Sub-scales

• Pain
• Symptoms
• Activities of Daily Living
• Sport and Recreation
• Participation in Physical Activity
• Quality of Life

Some of the important things to know about HAGOS.

A score of 100 indicates no problems relating to the hip or groin, 0 means severe problems.

The “minimal important change” (MIC) is defined as the smallest measured change in a score that patients perceive as important. The MIC for HAGOS sub scales sits between 10-15 points.

The Minimal Important Change for HAGOS sub-scales is 10-15 points.

The “smallest detectable change” (SDC) is a reflection of measurement error. For HAGOS the SDC varies between sub-scales and when considered for an individual or a population. For individuals SDC is 34 points for “participation in physical activity” (PA) and 15-18 points for all other sub scales. For groups, SDC ranges between 3-5 points. This tells us that HAGOS (as with many PROMs) is better at detecting change at the group level.

The Copenhagen Hip and Groin Outcome Score (HAGOS): development and validation according to the COSMIN checklist. K Thorborg, P Hölmich, R Christensen, J Petersen, E M Roos.